What Are the Best and Safest Techniques for a Secondary (Not Revision, Just Fading Results) Facelift?

   Depending upon the areas of concern, skin removal coupled with SMAS plication is a very safe technique will low risk of complications.  Find the plastic surgeon with ELITE credentials who performs hundreds of facelifts each year.  Kenneth Hughes, MD Los Angeles, CA

Depending on the previous operative procedure, one can either perform a SMAS plication or if the face is round and there is not significant scarring then one can do a SMASectomy. This all depends on the skill and expertise of the surgeon as well as the previous operative procedures.

This really depends on the patient.  In general, there are many different ways to perform a facelift, and a consultation with qualified surgeon can help determine the best procedure for you based on your individual needs. There are two main options to consider when deciding to have a facelift:

1) Traditional facelift: a great option for a patient with more advanced signs of aging who wants to refresh their neck, jawline, and cheeks.
2) Mini facelift: A less invasive facelift that rejuvenates the lower third of the face, including the jowls and neck.
 
There are also  a variety of additional procedures that can be used in conjunction with a facelift or mini facelift to achieve optimal results. These options include but are not limited to:

1) Liposuction of the jowl or neck
2) Fat transfer to the face
3) Cheek implants

Technique varies from surgeon to surgeon, and one can only tell what would be best for you following a thorough exam.  When seeking a touch up,  it is not likely you would need a very invasive procedure. But this can depend on what was performed during your initial surgery, and whether or not the procedure was performed properly.  A facelift typically lasts around 10 years before any touch ups are necessary.  Only an in-person exam and thorough evaluation can help determine the best option for you. I would recommend seeking the advice of a qualified facial plastic surgeon to help determine your next steps. Thanks and good luck!

Mini Facelift Effective Option for Secondary Facial Rejeuvenation following full facelift.

A full or "traditional" facelift  addresses the sagging upper and lower neck skin and (platysmal) vertical neck bands, jowls,  lower and mid nasolabial folds and marionette lines. It involves incisions from the temple scalp, along the front of the ear (inside the mid part for women), behind the ear in the crease then along or into the scalp hair behind the ear towards the back of your neck with undermining of the skin and  tightening of underlying support tissues. After this has been performed the aging process continues but most of the resultant sagging can be refreshed with a mini lift.

A mini-facelift, or "short scar facelift" or as I call it in my practice a LiteLift addresses all of the above except for the lower neck. The difference is that the incisions are shorter - basically the same description in front of the ear and temple scalp but ending at the level of the earlobe (in front or in back) - as much as 40% less scarring.We do most of these procedures with oral sedation and local anesthesia without IV's or general anesthesia.This seems to be the best choice for most of my patients wanting a secondary facelift procedure.

Other physicians have offered excellent advice about limited skin excision techniques, fat grafting etc.  Most if not all of which I agree with.

Let me offer you a completely different option which is becoming a very popular procedure in my Salt Lake City, UT cosmetic surgery practice which uses two different lasers to perform a "laser facelift".  No skin is removed and it is performed with 3 small incisions about 3-4 mm long.

The first laser is the Smartlipo laser which is used to undermine/separate the skin of the face and neck similar to what is performed with a standard facelift.  The laser also heats the skin to a precise temperature which stimulates collagen remodeling and tightening.  Once again, no skin is removed, I just stimulate the existing skin to shrink and tighten.

The second laser is the SmartSkin CO2 laser which is used to resurface the facial skin.  This also creates collagen remodeling and tightening as well as improvement in discolorations but this laser works from the surface of the skin down instead of beneath the skin like the other laser.

The downtime for this "laser facelift" is 3-4 days.  You look horrible for 24 - 36 hours, but rapidly improve. You will have pinkness or redness of your face for 3 -6 months which is easily concealable. The entire procedure can be done in my clinic with only local anesthesia so you are able to return home very quickly.

As with your original surgery the facial changes that you wish to correct are what determine the best surgical plan. For example if your neck line has relaxed then a neck lift would be most appropriate. If its fine wrinkling then a skin resurfacing procedure might suit you best. I would suggest meeting with your original surgeon, if available and go through the consultation process from the beginning and decide whats most important to you.

 Here a picture is worth a thousand words.  There are so many directions on could go.  I am going to make an assumption that surgical correction is the only option.  Minimally invasive techniques may be helpful short of surgery but without a picture I can't say.  The general principle in a secondary facelift would be to address the muscle laxity in the usually manner but the excess skin is much less.  

 

Dr. ES

A picture is worth a ......

The answer to your question varies depending on what you look like; your anatomy, hairline, amount of volume loss, extent of jowling and neck laxity,  quality of skin, ... etc

I have performed many secondary, and even tertiary facelifts, and every time the procedure is different depending on the findings above. 

'the best and safest techniques' are dependent on the 'best and experienced' surgeon. 

Your options for having a secondary facelift depend a lot on your current anatomy. A repeat facelift can certainly be done if the results from your original surgery are fading. You may want to consider improving facial volume loss as well (presuming you have this issue as well). Skin filler injection or fat transfer are methods to achieve this goal. This often provides even more durable, natural results.

The best and safest techniques for a repeat facelift are those that would be recommended by an accomplished and experienced plastic surgeon after considering your history and physical examination.

In general these are the areas that need particular attention in repeat facelift:

1. The various hairlines, which may have been displaced by the first facelift, must not be shifted further and may need to be restored to their proper positions.

2. Your surgeon may feel that at this point you need tissue replacement, as opposed simply to removing further tissue. If you have lost volume in your face your surgeon may recommend fat grafts to restore youthful fullness.

3. The previous scars must be considered in terms of their effect on skin circulation and their movement during the second procedure. 

4. Whatever techniques are used it is always paramount to avoid an overdone appearance. Your surgeon will suggest ways to freshen and rejuvenate without creating an obviously surgical appearance. 

Good luck!